The New Zealand medical journal
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Smokers need new products and policies to escape smoking's risks. And the next generation needs policies that will better protect them from becoming smokers. Low-nitrosamine tobacco snuff (hereafter termed 'snuff') is 20 times less dangerous than cigarette smoking. ⋯ Tax each class of tobacco products proportionate to the respective risks of each. (Tax cigarettes at 20 times the snuff rate, instead of at the same rate.) Legislate, to expand the Smoke-free Environments Act's aims to include ending the sale of cigarettes and ending smoking deaths--i.e: Allow oral snuff to compete with cigarettes for market share (and for the smoker's nicotine receptors). Reduce addiction to smoking, by decreasing the nicotine content of cigarettes by 5% every 6 months. (Below 20% of current levels, most smokers will quit or switch to snuff.), Allot cigarette supply quotas to manufacturers and importers, decreasing by 5% every 6 months, on the grounds that cigarette smoke is irremediably toxic. The summed effects of these changes could end cigarette sales within 10 years, and prevent 90% of cigarette deaths within 22 years thereafter.
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Stroke units save lives, reduce dependency, and increase the chance of returning home. A 15-bed Acute Stroke Unit (ASU) was opened on the acute hospital campus to complement an established Stroke Rehabilitation Unit (SRU) on a distant campus. The aim of this study was to address whether patient care was improved with the establishment of the ASU. ⋯ Adding an ASU to complement an existing SRU can give major improvements in PoC across many different facets of stroke care. We believe this is one step closer to both the ideals of an overall coordinated stroke service and better overall care for patients with stroke.
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Over the past decade, psychosocial issues have been increasingly identified as risk factors that are associated with the development of chronicity and disability. These psychosocial risk factors are known as Yellow Flags. In New Zealand, in 1997, the Accident Compensation Corporation (ACC) published the Acute Low Back Pain Guide and the Guide to Assessing Psychosocial Yellow Flags in Acute Low Back Pain. The aim of this qualitative study is to understand the experiences of general practitioners (GPs) in the identification and management of psychosocial Yellow Flags in patients with acute low back pain. ⋯ GPs did not use the Guide to Assessing Psychosocial Yellow Flags in Acute Low Back Pain or the screening questionnaire to identify psychosocial risk factors in their patients with low back pain. Investment of resources in GPs is needed to empower them to be effective gatekeepers guarding against chronicity. This demonstrates a need to alter the current ACC Guideline dissemination and implementation.
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Comparative Study
Punitive parenting practices of contemporary young parents.
To describe the punitive parenting practices of a cohort of young (<25 years) New Zealand parents and to examine the life course risk factors that placed these parents at increased risk of severe child physical punishment/abuse. ⋯ The use of physical punishment and more severe forms of physical assault/abuse are relatively common amongst contemporary young parents. Implications of study findings for social policy aimed at reducing levels of family violence in New Zealand are considered.
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Comparative Study
Prevalence of complementary and alternative medicine use in Christchurch, New Zealand: children attending general practice versus paediatric outpatients.
There is little information about the use of complementary and alternative medicines (CAM) in New Zealand children who attend a general practitioner for intercurrent illness compared to children attending secondary care with a chronic condition where CAM use is high. This study aims to establish whether there are differences in prevalence and non-disclosure rates, information sources, and potential predictors of CAM use in these two populations of children. ⋯ CAM-use amongst New Zealand children is higher, and disclosure rates lower, when compared to overseas populations of children. This suggests that there is greater potential for New Zealand children to be at risk of adverse events directly and through interaction with prescribed medicines. Contrary to expectations, CAM-use behaviours and disclosure rates are comparable between GP and outpatient populations--suggesting that all prescribers need to explicitly ask parents about CAM-use with their children, particularly those that report CAM-use themselves.